Provider Demographics
NPI:1104581099
Name:AMADOR ZAVALA, CARLOS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:AMADOR ZAVALA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9322 WANDSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-9406
Mailing Address - Country:US
Mailing Address - Phone:438-142-2164
Mailing Address - Fax:
Practice Address - Street 1:12097 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-1001
Practice Address - Country:US
Practice Address - Phone:281-444-6304
Practice Address - Fax:281-444-1390
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-04
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28303183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist